Individual
TRUNG DUC PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRX
Contact information
Practice address
6615 NE GLISAN ST, PORTLAND, OR 97213-5068
(503) 797-6973
Mailing address
6615 NE GLISAN ST, PORTLAND, OR 97213-5068
(503) 797-6973
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9948
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PRH-0009948
OR
Other
Enumeration date
06/28/2013
Last updated
04/26/2017
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